If you have been living in Sofia for a while, you must already be familiar with the name. It belongs to the largest emergency hospital in the country. The tall, rather drab building on Tsar Boris III Boulevard has seen countless casualties arrive by ambulance or taxi after suffering accidents or becoming victims of crime, to be treated by some of Bulgaria's finest medical specialists.

The Pirogov Hospital was founded in 1951 to replace the older Red Cross Hospital as a centre for accident and emergency. It was modelled after similar institutions in the USSR, as a result of the trend in the first decade after the 1944 Communist coup, when Bulgaria's economy, institutions and culture were remodelled along Soviet lines.

Its namesake, surgeon Nikolay Pirogov (1810-1881), however, had nothing to do with the USSR. He was a pioneering physician who revolutionised war-time field surgery and played a significant role in the Russo-Turkish War of 1877-1878, which restored the Bulgarian state.

A prodigy in medicine, Pirogov graduated at the age of 18 from Moscow University and at 26 was already a professor at the University of Dorpat (today's Tartu in Estonia). He then specialised in surgery, created the first anatomical institute in Russia and wrote two studies on anatomy, which collectively comprised 16 volumes. He made headlines, too. One of his most famous operations was an aesthetic one, where he used skin from a patient's chin to replace a missing part of the man's nose.

Pirogov came up with some of his most significant innovations while caring for the wounded of Russia's wars. In 1847, during the seemingly endless Caucasus conflict in which Russia was embroiled, Pirogov performed the first field surgery in the world under ether anaesthesia. This happened only a year after this ground-breaking method of anaesthesia was publicly demonstrated at the Ether Dome in Boston, Massachusetts.

Monument to Pirogov and his work near Svishtov, marking the place of one of the hospitals he organised during the Russo-Turkish War of 1877-1878

When the Crimean War broke out, in 1853, the Russians soon found themselves overwhelmed with wounded soldiers suffering and dying in horrendous conditions. In 1854, Pirogov arrived in Sevastopol, in the Crimea, to help. He had to fight not only for the lives of thousands of soldiers, but also against the corruption that was rife in the medical administration. He succeeded in providing a smooth organisation, and introduced the triage system, which divided the wounded according to the severity of their injuries.

This system is still in use in emergency hospitals, including in Sofia's Pirogov.

Another innovation of Pirogov's during the Crimean War was the plaster cast for injured limbs. It sounds like nothing major now, but at the time it saved many legs and arms from being amputated.

Pirogov's achievements were widely praised after the end of the war in 1856, but this did not make life easier for him. The surgeon became the victim of political manoeuvring in top medical circles and fell out of favour with the tsar. Isolated and left without a pension, in 1866 Pirogov went to Vishnya, or Sour Cherry, his family mansion near Vinnytsia, in today's Ukraine, and opened a free hospital for the poor.

He continued travelling and learning more about the human anatomy and the ways a surgeon could help. Pirogov visited Europe, became an honorary professor at a number of universities and academies, and went to the battlefields of the Franco-Prussian War of 1870. His fame grew, and his list of well-known patients included Giuseppe Garibaldi, the leader of the Italian unification movement.

In 1877, Russia began a new war against the Ottoman Empire, and the skills and devotion of Pirogov were again much needed.

The surgeon went to one of the most difficult front lines, that at Pleven, and in only two months made significant improvements in medical care for the wounded.

Pirogov's hospital for the poor, Vinnytsia. It is closed to visitors, but in the nearby surgeon's mansion there is an informative museum dedicated to his work

Pirogov spent the rest of his life in Vinnytsia. In 1881, the 50th anniversary of his scientific career was celebrated officially in Moscow and St Petersburg, the cities where previously he had had so much trouble. By this time, however, Pirogov was dying of upper jaw cancer. As a surgeon, he knew that this was incurable and he prepared for death in a rather eccentric way.

He developed an embalming solution and declared in his will that his body should be preserved. This was duly done after his death on 23 November 1881. His body was later laid in the crypt of the family chapel his widow built near the mansion at Vishnya.

The body of the surgeon is still there, in the crypt. The room has no equipment for preserving a specific temperature or humidity, yet Pirogov's body is in perfect condition. It seems as if the years since 1881 have barely passed.

Later, Pirogov's successful embalming technique was put to political use. When Lenin, the first Soviet leader, died, he was also embalmed. After the Second World War the practice was followed by Communist Bulgaria, with the dead Stalinist dictator Georgi Dimitrov, and by Czechoslovakia with Klement Gottwald. Of these, today only Lenin is still in his mausoleum. However, in spite of the controlled conditions and the constant care in his grandiose tomb on Red Square, Lenin's body is deteriorating – not just symbolically.

Pirogov's mummy

The chapel built to preserve Nikolay Pirogov's mummified remains

Goat herder on the outskirts of Vinnytsia. The area was called Pirohove, after the surgeon who lived, worked and died there

1 comment

thank you very much for this detailed, elaborated and well written article about Nikolay Pirogov, a man to be known better especially in western countries, where I come from (Germany). I have been a few times to this hospital in Sofia - not as a patient, but as a compagnion to somebody, who needed immediate help.
I was wondering, where the name "piro" came from, that's why I searched for his name and how I found your text. The missing link you gave me, was the commitment of Pirogov in Pleven, thanks for that. Best wishes Axel

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